Summary of "Practical and Intuitive Surgical Approach Renal Ranking (SARR) to predict outcomes in the treatment of renal tumors: a novel score tool."

Background and Purpose: Surgery continues to be the main form of treatment for renal tumors. We create a more practical and intuitive score for renal tumor classification. Materials and Methods: 80 patients underwent surgery for renal tumors and were prospectively enrolled. The tumors were classified using the following variables: (1) tumor size, (2) endophytic or exophytic tumor, (3) longitudinal location of the tumor, (4) the extent of the impairment renal parenchyma, (5) relationship with the renal sinus, (6) anterior or posterior. Results: The mean operative time, tumor size and bleeding increased proportionally to the increased complexity of the tumor measured by scores (p<0.0001, p<0.0001 and p=0.036, respectively). The mean total score was 8.7 points for patients undergoing partial nephrectomy (PN) and 14.4 points for those undergoing radical nephrectomy (RN) (p<0.0001). Larger tumors, completely endophytic, which exceeded the renal medulla and centrally located underwent radical nephrectomy (RN) more often (86.7% - p<0.0001, 64% - p=0.01, 77% - p<0.0001 and 78.9% - p<0.0001, respectively). In univariate analysis, RN was associated with tumors larger than 7 cm (p=0.001), tumors that exceeded the renal medullary (<0.001), centrally located tumors (OR=150 p <0.001) and tumors of high complexity (p<0.001). Analysis showed no association between complications and variables in the score. The findings were similar when the tumors were evaluated with the R.E.N.A.L. score system. Conclusion: SARR is a simple, practical and intuitive classification for renal tumors that can be used in the decision-making process and to predict outcomes in the surgical treatment of renal tumors.

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Medical and Biotech [MESH] Definitions

Gingivectomy

Surgical excision of the gingiva at the level of its attachment, thus creating new marginal gingiva. This procedure is used to eliminate gingival or periodontal pockets or to provide an approach for extensive surgical interventions, and to gain access necessary to remove calculus within the pocket. (Dorland, 28th ed)

Diskectomy, Percutaneous

Percutaneous excision of a herniated or displaced intervertebral disk by posterolateral approach, always remaining outside the spinal canal. Percutaneous nucleotomy was first described by Hijikata in Japan in 1975. In 1985 Onik introduced automated percutaneous nucleotomy which consists in percutaneous aspiration of the nucleus pulposus. It is carried out under local anesthesia, thus reducing the surgical insult and requiring brief hospitalization, often performed on an outpatient basis. It appears to be a well-tolerated alternative to surgical diskectomy and chymopapain nucleolysis.

Renal Plasma Flow

The amount of PLASMA that perfuses the KIDNEYS per unit time, approximately 10% greater than effective renal plasma flow (RENAL PLASMA FLOW, EFFECTIVE). It should be differentiated from the RENAL BLOOD FLOW; (RBF), which refers to the total volume of BLOOD flowing through the renal vasculature, while the renal plasma flow refers to the rate of plasma flow (RPF).

Hypertension, Renal

Persistent high BLOOD PRESSURE due to KIDNEY DISEASES, such as those involving the renal parenchyma, the renal vasculature, or tumors that secrete RENIN.

Reversal Learning

Any situation where an animal or human is trained to respond differentially to two stimuli (e.g., approach and avoidance) under reward and punishment conditions and subsequently trained under reversed reward values (i.e., the approach which was previously rewarded is punished and vice versa).

Relevant Topic

Renal diseaseChronic kidney disease (CKD), also known as chronic renal disease, is a progressive loss in renal function over a period of months or years. The symptoms of worsening kidney function are non-specific, and might include feeling generally unwell and experi...